Welcome to the November edition of i2P – Information to Pharmacists.
The month just finished has been an exceptionally busy one for pharmacy with an interesting PAC being concluded.
The “Great Debate” from PAC stirred considerable interest, also the talk given by John Menadue.
The latter has been reported and commented on in the article “Pharmacy’s Professional Future” and it is recommended that this article be bookmarked.
Better still, add your comment at the foot of the article.
All our columnists are back on deck and we are delighted to report that our New Zealand columnist, John Dunlop, has been accorded high honours by the New Zealand Pharmaceutical Society.
See the article in the Recent News section or look for the editor’s logo in the column section.
Our congratulations go out to John for this honour that resulted from his work in the pharmacy professional services area..
Volume 1 Number 1
Volume 1 Number 2
Volume 1 Number 3
Volume 1 Number 4
Volume 1 Number 5
Volume 1 Number 6
Volume 1 Number 7
Volume 2 Number 1
Volume 2 Number 2
Volume 2 Number 3
Volume 2 Number 4
Volume 2 Number 5
Volume 2 Number 6
Volume 2 Number 7
Volume 2 Number 8
Volume 2 Number 9
Volume 2 Number 10
Volume 2 Number 11
Volume 3 Number 1
Volume 3 Number 2
Volume 3 Number 3
Volume 3 Number 4
Volume 3 Number 5
Volume 3 Number 6
Volume 3 Number 7
Volume 3 Number 8
Volume 3 Number 9
Volume 3 Number 10
Volume 3 Number 11
Volume 4 Number 1
Volume 4 Number 2
Volume 4 Number 3
Volume 4 Number 4
Volume 4 Number 5
Volume 4 Number 6
Volume 4 Number 7
Volume 4 Number 8
Volume 4 Number 9
Volume 4 Number 10
Volume 4 Number 11
Volume 5 Number 1
Volume 5 Number 2
Volume 5 Number 3
Volume 5 Number 4
Volume 5 Number 5
Volume 5 Number 6
Volume 5 Number 7
Volume 5 Number 8
Volume 5 Number 9
Volume 5 Number 10
Volume 5 Number 11
Volume 6 Number 1
Volume 6 Number 2
Volume 6 Number 3
Volume 6 Number 4
Volume 6 Number 5
Volume 6 Number 6
The recent “Great Debate” at the 2009 Pharmacy Australia Congress had an excellent topic choice (“The answer to our future is increasing front of shop sales, not professional services”).
The answer is, of course, that pharmacies need both activities as “core business” to survive – it just depends on what balance is required for each unique pharmacy practice sufficient to allow for differentiation and emphasis on specialties (whether professional services or retail activities).
However, it could be argued that policies in recent years have tipped the balance in favour of supply services that favour retail activity.
Little research or effort has gone into the development of professional services (there is actually major amounts of unspent grant money from the Fourth Agreement), so many pharmacies see little relevance in promoting services they may not have the training for, or the infrastructure to deliver the necessary training (which comes at a cost).
Recently I received a number of calls from a concerned relative of one of our veteran clients currently in an aged care facility.
The problems I am hearing about relate to the difficulty in getting the patient’s doctor to write prescriptions for necessary medications, echoing many of the stories I heard during my pharmacy visits about the problem of “owing scripts” and just how hard it is for pharmacists to get them written. If we break down the problem we get this sequence of events:
Is talking about talk the best way to start solving the sharing of data in a health informatics scenario?
I have often written on the subject off interoperability; referring to broken and failed systems and in the attempts to get everyone in healthcare, primarily inside a hospital, to exchange information without re-working it all the time.
This can be a complex subject matter because it has little to do with technology and all to do with people. If various departments and fiefdoms want to share their data it can happen; if they behave in a recalcitrant manner, it won’t happen.
Which takes us down a path, for perhaps another time, regarding the subject of IT systems and collaboration? We Australians are not good at this – there is something in our makeup that resists sharing certain things, notably information management systems. Not sure whether it is a streak of independence or immaturity, or both. Anyway, moving on to the matters at hand, let’s continue.
There is power in numbers.
It is said that Chemist Warehouse is growing at 25/30% per annum, the traditional franchises are growing at about half that rate and the poor old unbranded Pharmacy is trailing behind at about 10%. This really means that Chemist Warehouse is flying along with a wet sail doing nicely and all others are wondering where to find growth or are spending far too much time with their accountants’ trying to work out how to survive the future.
This is no surprise of course; the Chemist Warehouse business model is brilliant, they are compelling marketeers and proof that the power in numbers prevails.
When you think about it, genetics are likely to determine your skin type.
It is little wonder that if one or more of your relatives, including your ancestors, had a predisposition to skin cancer, then you may have inherited that trait.
Researchers believe that there is up to a 50 percent risk involved that you will develop skin cancer through genetic inheritance.
Skin cancer can be inherited: studies
Editor: It is good to see the New Zealand medical professionals getting behind climate change strategies in their country.
Pharmacy, particularly here in Australia is conspicuous by its absence in this activity.
Yet there are many things we can influence - particularly in the areas of the supply chain, shop design and the type of fixtures and fittings we select.
Unless we all begin to be proactive in this area, events will pass us by to our detriment.
Add your comments at the foot of this article to start off a discussion.
Source: New Zealand Medical Journal
Article written by: Scott Metcalfe, Alistair Woodward, Alexandra Macmillan, et al; for the New Zealand Climate and Health group
In Issue number six of Pharmacy e-Edge, the newsletter of the Pharmaceutical Society of New Zealand, four New Zealand pharmacists were awarded a range of honours. The report was prepared by Richard Townley, the CEO of the Society. Among them was John Dunlop, our i2P writer representing New Zealand, and we are pleased to share in John's achievement. John was awarded a Fellow of the Pharmaceutical Society of New Zealand in recognition of his outstanding contribution to the advancement of the practice of pharmacy in New Zealand. Congratulations John!
In a press release by Dr Allan Bell of Auckland University of Technology (sure to raise eyebrows with some Australian i2P readers), it is stated that:
"The New Zealand accent has been rated the most attractive and prestigious non-British form of English, according to a BBC survey.
New Zealand English came in first ahead of Australian, American and most regional British accents in the study published in the international Journal of Sociolinguistics, edited by Professor Allan Bell, Director of AUT’s Institute of Culture, Discourse and Communication."
Choosing your rice variety may provide an inexpensive support for a program to treat diabetes.
Menus involving varieties of brown rice may reduce glycation and the rate at which sugar is absorbed by the body.
Cinnamon is another food known to sensitise insulin and reduce sugar levels.
With a some thought it appears that a variety of foods that combat diabetes could be combined to create dishes that are not only functional, but delicious to eat as well.
Brown rice could aid diabetes control
By Anuradha Alahakoon
It was refreshing to read some positive recent announcements, comments and opinions in the media over the past three weeks.
First was the announcement by Nicola Roxon regarding the National Preventive Health Agency and the positioning by the Pharmaceutical Society of Australia firmly in support of this development of her initiative.
It is not quite 12 months ago that i2P ran a story on Nicola Roxon, her family and political background, at a time when she was relatively unknown in health circles.
Some observational and predictive points from that i2P article dated December 2008 -"Have you met Nicola Louise Roxon?" -are shown below.
Go to http://archive.i2p.com.au/?page=site/article&id=1168 for the full article.
"* Nicola appears to be a very normal and stable personality with strong family values, and is direct, straightforward and honest in her professional life.
* Nicola will endeavour to broaden the concept of health from illness treatment to illness prevention. She is well documented in many statements that “prevention is better than cure”.
* Pharmacy will be included within primary health care (something that other professions have tried to restrict), and the role pharmacy already plays in self-care will be recognised. I am sure that funds will be made available for the extension of self-care, work that has always been unpaid work performed by pharmacists.
* Nicola, however, needs to understand exactly what depth pharmacists have provided primary care, almost in a secretive fashion, because of constant harassment by doctors. While there is a surface cooperation between doctors and pharmacists, it is really only lip service.
The removal of this harassment would allow pharmacists to thrive as well as the general public.
* Nicola also needs to understand that while pharmacy owners provide infrastructure to provide medicine distribution, the pressure of this infrastructure works against the development of clinical services.
For this role she needs to recognise pharmacists individually as health practitioners and separate their income from the PBS model.
By providing incentives to individual pharmacist practitioners, development ideas and capital would flow in from these people and pharmacy owners would form beneficial relationships to harness benefit for the supply side of their businesses.
* From the recent address given at the Pharmacy Guild of Australia annual dinner, Nicola said, in part:
“The examples of existing Professional Programs and Services confirm the pharmacist’s role within the primary healthcare team.There may still be some debate about the borders of that role – but the direction is already well and truly established.
I want to be clear here – and I suspect my earlier comments have already given this away – any expanded role for pharmacists will take an incremental approach, and will be dictated by the need for safety and quality in health care.”
In other words, she will do what she has always done – carefully plan and test any program before it becomes policy.
It would seem that we were substantially correct and that the National Health Preventive Agency will offer a great opportunity for pharmacists to take advantage of their current training and skills set.
The second item was contained in a press release by the PSA dated 16/10/09 regarding a Memorandum of Understanding that was signed in Sydney by the President of the PSA, Warwick Plunkett, and the President of the RACGP, Dr Chris Mitchell, at a ceremony during the Pharmacy Australia Congress.
While details of the memorandum still have to be released, it may eventually mean that pharmacists will be able to practice independently and in alliance with GP's without the constant sniping that has been a feature of a relationship, which if worked cooperatively, has always been proven to provide maximum patient benefit. Good work PSA!
The third item of interest was an opinion article written by Geoff Marsh, president of APESMA.
Few comments have originated from APESMA, so it was good to see a comment from this organisation, as is really the voice of non-pharmacy owners, or to put it more succinctly, the logical representative of the pharmacists who provide professional services (whether or not they are paid up members).
The following appeared in Pharmacy e-News on 23/10/09 (located at
Rollo Manning has experienced pharmacy practice from all sectors of the industry – retail, administrative, policy and remote Aboriginal practice. He spent 10 years with Glaxo Australia and was the first Director of Public Relations at the Pharmacy Guild National Secretariat in Canberra.
There is an 800 bed hostel in Darwin that houses a capacity clientele all the time and 90% of the residents are Aboriginal people, in the main men.
It is called Berrimah Gaol and it is for people who have chosen to do things that are anti social, abusive, and dangerous to others. In choosing to go down a path of “badness” in life they have been rewarded with a stay in this hostel for periods varying depending on the nature of the act they committed.
There is an 800 bed hostel in Darwin that houses a capacity clientele all the time and 90% of the residents are Aboriginal people, in the main men.
The fact there are so many Aboriginal men in prison is an indicator of the social despair they have come from in their home communities where alcohol, drugs, crowded houses, poor education and no jobs are the order of the day. They have come from an environment which has puzzled the authorities and policy makers for the past 40 years since these people were give full citizenship rights to the country they have lived in for the past 40,000 years.
The story is well known to anyone in Australia that follows the Government debate on the welfare of the First Australians – the Aboriginal and Torres Strait Islander people who number 520,000 or about 2.3% of the total population. The visitor to Australia (and the Northern Territory in particular) will learn of the devastating life style the people from this race are experiencing through their life in remote communities often 700 Kms from any part of the “developed” world. Their view of the world is so far removed from the reality of the New Australia that to understand the conflicts requires a close anthropological study of their daily life.
So they are the negatives and frequently that is all anyone hears about. The system that has been constructed by the Federal Government is so geared towards alleviating disadvantage that it has missed the boat in trying to promote advantage.
A young Aboriginal woman from a remote community can come to Darwin intent on carving out a good life for herself and her people that she struggles to get any help. Not so for her brothers or sisters in prison. They had no trouble attracting attention and finding a bed to sleep in. The young woman, who shall be called Dulcie, got to Year 12 at school in the remote community but fails to be able to read or put together a sentence in writing. Her understanding of numbers is quite good but an appreciation of the value of money not good.
So the system allows for her to be able to receive Centrelink benefits on the understanding of a mutual obligation – to undertake training and look for a job. Okay – sounds good and after registering with Centrelink her first payment comes through on 31st July. The agreement – that she attends a Job Service Agency and undertake training. It is now 31st October but still no training. Many appointments and some even broken by the Job Service Agent whose officer failed to show – had Dulcie failed to show she might have had her payments cut off. Not so for the Job Service Agent – so where is the mutual obligation there? And how do these people get paid? It is certainly not on results as three months with no training is just disastrous for Dulcie and the hundreds like her. What do the authorities in Canberra that devise these programs expect a person like Dulcie to do all day? Surely there is a better way to engage the young who want to do good in life or are the authorities too focused on the disengaged youth that they don’t have time to consider preventative action like engaging those that want to do good.
However next week is an exciting one for her because training starts on 3rd November in learning literacy, numeracy and understanding money. The location for the training? – Charles Darwin University. There is no doubt about doing things in style. To anyone in mainstream Australia going to University is the pinnacles of learning – but for Aboriginal Australians there are no half measures – we send them to University to learn to read and write maybe hoping University life is a good experience and they decide to stay on!!
How ridiculous can it get when schooling is a learning experience through the years from aged five or six through to 16 or 17 after which there are a range of options for a career path. Poor Dulcie cannot read or write so her choices of a career path are framed by the limitations from her learning experiences. Maybe a hairdresser- they stand up all day using there hands – or maybe a motor mechanic – they lie around under or over cars fixing things with spanners and it does not look as though you would have to read for that. But the main choice is being a cleaner – then you surely would not have to read.
So when Dulcie does come to town wanting to improve herself where is the help? It is not at Centrelink that just push her off to another agency after filling out a few forms she had no idea of - and when the Job Service Agency makes appointment after appointment and no training just what are they testing? Maybe ones ability to know what day it is and to tell the time – week after week and still no training.
There needs to be established a residential facility in Darwin (like the Gaol for the bad guys) where young women can live and attend a planned schedule of training and work experience. Until the “system” learns to identify the good ones we will only see role models coming forward from the prisons for the younger ones.
How many University graduates have come out of Arnhem Land in the past 40 years – not counting those learning to read and write? The answer is very few and until that is turned around the disadvantage will continue to lead the stakes in spending Government money.